Medicare cost report

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Medicare cost reports are used to report expenses for different types of Medicare reimbursable facilities, such as Skilled Nursing Homes (SNFs), Home Health Agencies (HHAs), Home Offices, Hospices, Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), and hospitals. [1]Every facility must complete and file a cost report on a yearly basis, with some extenuating circumstances requiring more frequent cost reports. CMS, the United States government organization in charge of Medicare, regulates the specific requirements for these reports.[2]

Medicare cost report software is strictly monitored to be CMS-compliant so that reports will be accurate and fulfill all requirements. Approved software must be updated regularly to remain compliant with regulations. Only software from an approved vendor may be used.

Cost reports must be submitted in electronic format, known as Electronic Cost Reports or ECRs. They used to need to be submitted via floppy disk, CD, or flash drive only. Submission requirements include submitting the ECR files and the signed signature sheet. Supporting fiscal documentation is required, and may vary by fiscal intermediary a.k.a. MAC (Medicare Administrative Contractor).[3] Cost reports used to be submitted to a facility's fiscal intermediary, assigned by the CMS, only by mail or courier.

New cost reporting rules allow for cost report signature pages to be signed "electronically". This means that they may be signed on the software itself or signed and then scanned back into a computer as long as the "Electronic Signature" checkbox on the signature page is checked. If it is not checked, the original, signed signature page must be sent in hard copy format.[4]

Cost reports may now also be filed online through the new MCReF (Medicare Cost Reporting eFiling) portal.[5]

Cost reports are due five months after the fiscal year end. Any delays are subject to withholding of Medicare reimbursement. Facilities will try to use these cost reports to maximize legal reimbursement by ensuring correct filing and reporting of fiscal data. Facilities with low or no Medicare utilization need to submit a low-utilization cost report, which does not include an ECR.[6]

The cost report forms often change to reflect changes to regulations, as evidenced by the changes brought by the aforementioned e-filing system. Major changes will result in new transmittals of the forms.[7] While the forms are downloadable from the CMS website (see list of forms below), the forms from the website cannot be used to actually complete the cost report, since they do not create the ECR files.[8]

Cost Report Forms[9][edit]

As of 2017, the following are the updated cost report forms by facility for the more common providers:

  • Form 1728: Home Health Agency[10]
  • Form 2540: Skilled Nursing Facility[11][12]
  • Form 287: Home Office[13]
  • Form 1984: Hospice Facility[14]
  • Form 222: RHC[15]
  • Form 224: FQHC[16]
  • Form 2552: Hospitals[17][18]


  1. ^ "Cost Reports". Center for Medicare and Medicaid Services. Retrieved 29 June 2015. 
  2. ^ "Cost Reporting". Centers for Medicare and Medicaid Services. CMS. Retrieved 29 June 2015. 
  3. ^ "Medicare Cost Report Help - FAQs - PPS". 
  4. ^
  5. ^
  6. ^ "FAQs - Cost Reporting". Progressive Provider Services. Retrieved 29 June 2015. 
  7. ^ "New Transmittals for Cost Report Software - Be Prepared". 
  8. ^ "Do I Need to Purchase Software for My Medicare Cost Report". 
  9. ^ "Overview". 13 February 2018. 
  10. ^ "CMS Form 1728" (PDF). 
  11. ^ "Instructions for Form 2540". 
  12. ^ "Form 2540-CMS". 
  13. ^ "Form 287". 
  14. ^ "CMS-1984-14". 
  15. ^ "Form 222". 
  16. ^ "Form 224". 
  17. ^ "Simple version Form 2552". 
  18. ^ "Complex version of Form 2552".